FY 2017 ANNUAL COMPLIANCE REPORT PRESENTATION TO MHBE BOARD OF - - PowerPoint PPT Presentation

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FY 2017 ANNUAL COMPLIANCE REPORT PRESENTATION

TO MHBE BOARD OF TRUSTEES OCTOBER 16, 2017

PRIVACY INCIDENTS FY2017 (7/1/16 – 6/30/17)

• 167 Reported Incidents
• 84 Breach notifications
• 3% decrease in overall incidents reported

FY16 – 172 FY17 – 167

• 4% increase in rate of misloaded documents

1.58 v. 1.65 per 10,000 loads (97 misloads in 586k uploads)

• 9% increase in rate of CSR phone incidents

2.54 v 2.81 per 100,000 calls (28 errors in ~1 million calls)

• 58% Incidents Reported were misloaded VCL documents

MITIGATION STRATEGIES

 Reconstituted Incident Review Team

• Cross-functional analysis
• Expedited Mitigation

 System Enhancements

• Ability to audit records at user level
• Addition of screen prompts for Workers to validate identity of

consumer against document to be uploaded

• Ability for MDH workers to upload directly into system

 Improved Visibility & Accountability  Implemented Corrective Action Plans (CAPs) and Plan of Action and Milestones (POA&Ms)

10 20 30 40 50 60 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

Privacy Incidents - FY16 vs. FY17

Incidents Reported - FY16 Incidents Reported - FY17

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OFFICE OF LEGISLATIVE AUDIT (OLA) FINANCE PERFORMANCE Triennial Survey 2014

 Procurement Policy Adherence  Consultant Timekeeping  Federal Fund Reimbursement Requests  Connector Entity Expenditures and Invoice Controls  Inventory Control and Reconciliation  Open Meetings Act Compliance  Personally Identifiable and Federal Tax Information Inventory  Role-based Access Controls  Service Organization Control (SOC) 2, Type 2 Audits for Vendors  Intrusion Detection Prevention System and Worker Portal Access

EXTERNAL AUDIT RECOMMENDATION STATUS AS OF YEAR END FY2017

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State-based Market Annual Reporting Tool (SMART) for Plan Year 2015

 Incarceration Verification Process  Eligibility and Enrollment in Employer Sponsored Coverage Verification  Program Level Reporting Data Submission to CMS  Section 1557 of Affordable Care Act Compliance – Nondiscrimination  Comprehensive Annual Financial Report (CAFR) and Financial Document Submission  Independent Audit PY 2015 Status Updates to CCIIO

EXTERNAL AUDIT RECOMMENDATION STATUS AS OF YEAR END FY2017

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Independent External Finance and Programmatic Audit for Plan Year 2016

 Segregation of Journal Entry Duties  Incarceration Verification Process  Improve Internal Audit Process – QHP enrollment

EXTERNAL AUDIT RECOMMENDATION STATUS AS OF YEAR END FY2017

Updated Compliance Plan and Related Procedures Code of Conduct Maintained Anonymous Reporting Hotline Investigated 9 Compliance Hotline Complaints Collaborated in CCIIO Compliance Officer Meetings Increased Oversight and Monitoring Independent External Finance and Programmatic Audit Completed Government Accountability Office Audit Revised 2017 Annual Compliance Training and Attestation

Fraud, Waste and Abuse

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